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Studio sui farmaci antiepilettici aggiuntivi (ASM) Real World Evidence (RWE).

Uno studio osservazionale prospettico di 12 mesi in pazienti adulti con crisi epilettiche focali che sono trattati con ASM aggiuntiva nel mondo reale

The purpose of this study is to describe the effectiveness of the adjunctive ASM treatment on the clinical response, safety profile and quality of life of patients affected by focal onset seizures in a real-world setting.

Panoramica dello studio

Stato

Completato

Condizioni

Intervento / Trattamento

Descrizione dettagliata

The aim of the study is to assess the effectiveness and safety of adjunctive therapy in a real-world setting of patients affected by focal-onset seizures who are eligible to start the treatment with ASM as adjunctive therapy according to the physician's judgment.

Tipo di studio

Osservativo

Iscrizione (Effettivo)

332

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

      • Milan, Italia, 20133
        • Fondazione IRCCS Istituto Neurologico "Carlo Besta" U.O. Epilettologia Clinica e Sperimentale - Centro di Medicina del Sonno

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

Da 18 anni a 99 anni (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Metodo di campionamento

Campione di probabilità

Popolazione di studio

Adult patients with epilepsy having focal-onset seizures with or without secondary generalization not adequately controlled despite a history of treatment with at least 2 anti-seizure medications and who will meet all the inclusion and none of the exclusion study criteria.

The patients should be eligible to start a treatment with ASM as adjunctive therapy according to the physician's judgement, that must be clearly separated from the physician's decision to include the patient in the current study. The patients will be prospectively observed up to 12 months after having completed the related titration.

Descrizione

Inclusion Criteria:

  • Male and female patients of any ethnic origin ≥18 years old at baseline.
  • Patients with diagnosis of focal-onset seizures with or without secondary generalization.
  • Patients should have been eligible to start treatment with ASM as adjunctive therapy according to the physician's judgement prior to the inclusion.
  • Patients should have clinical history of treatment failure with at least 2 ASMs.
  • Patients using their seizure diary as part of their standard of care for at least 3 months prior to -the study entry (diary can be paper or electronic, filled in by patient and/or family members).
  • Written informed consent (including data privacy consent) signed by the patient, legal guardian, or legally authorized representative prior to entering the study in accordance with the ICH GCP guidelines

Exclusion Criteria:

  • Patients who meet any of the contraindications to the administration of adjunctive ASMs according to their approved SmPC.
  • Progressive neurological disease, including degenerative CNS diseases and progressive tumors.
  • Patients with unstable psychiatric diagnosis that may confound participants' ability to participate in the study or that may prevent completion of the protocol-specified assessments (e.g., in the judgement of the Investigator, pose an appreciable risk for suicide, including suicidal behavior and ideation within 6 months prior to enrollment, current psychotic disorder, acute mania).
  • Evidence of clinically significant disease (e.g., cardiac, respiratory, gastrointestinal, renal disease) that in the opinion of the Investigator could affect the participant's safety or interfere with study assessments.
  • Patients with substance abuse or dependence (except for caffeine and nicotine).
  • Patients participating in any pharmacological or nonpharmacological interventional study within 30 days prior to baseline.

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Modelli osservazionali: OTHER
  • Prospettive temporali: PROSPECTIVE

Coorti e interventi

Gruppo / Coorte
Intervento / Trattamento
Adult patients with focal-onset seizures starting a treatment with ASM as adjunctive therapy

Adult patients having focal-onset seizures not adequately controlled despite a history of treatment with at least 2 ASM.

The patients should be eligible to start a treatment with ASM as adjunctive therapy.The patients will be prospectively observed up to 12 months after having completed the related titration.

ASM approved as adjunctive therapy

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Change in seizure frequency at 6 months of maintenance
Lasso di tempo: At 6 months of maintenance compared to baseline

The effectiveness of adjunctive ASM is measured as change in seizure frequency at 6 months of maintenance compared to baseline

At 6 months of maintenance compared to baseline

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Change in seizure frequency at 3, 9, 12 months of maintenance
Lasso di tempo: At 3, 9, 12 months of maintenance compared to baseline

The effectiveness of adjunctive ASM is measured as change in seizure frequency at 3, 9, 12 months of maintenance compared to baseline

At 3, 9, 12 months of maintenance compared to baseline
50, 75, 90 Percent Responder rate
Lasso di tempo: At 3, 6, 9, and 12 months of maintenance phase.

The effectiveness is measured as 50, 75, 90 Percent Responder rate

At 3, 6, 9, and 12 months of maintenance phase.
100 Percent Responder rate
Lasso di tempo: At 3, 6, 9, and 12 months of maintenance phase.

The effectiveness is measured as number/percentage of seizure free patients

At 3, 6, 9, and 12 months of maintenance phase.
Retention rate
Lasso di tempo: At 3, 6, 9, and 12 months of maintenance phase.

The effectiveness is measured as percentage of patients remaining in the study and on adjunctive therapy

At 3, 6, 9, and 12 months of maintenance phase.
Anxiety assessment
Lasso di tempo: At baseline, immediately after completion of titration, at 3 months, 6 months, and 12 months of maintenance phase.

The assessment is measured by means of the Generalized Anxiety Disorder (GAD-7) scale. Scoring GAD-7 Anxiety Severity is calculated by assigning scores of 0, 1, 2, and 3 to the response categories, respectively, of "not at all," "several days," "more than half the days," and "nearly every day." GAD-7 total score for the seven items ranges from 0 to 21. 0-4: minimal anxiety 5-9: mild anxiety 10-14: moderate anxiety 15-21: severe anxiety.

At baseline, immediately after completion of titration, at 3 months, 6 months, and 12 months of maintenance phase.
Depression assessment
Lasso di tempo: At baseline, immediately after completion of titration, at 3 months, 6 months, and 12 months of maintenance phase.

The assessment is measured through the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) scale. This is a validated screening tool for depression in patients with epilepsy that consists of a 6- item questionnaire. NDDI-E scores greater than 15 were considered positive for depression, as this score was previously shown to have a specificity of 90%, sensitivity of 81%, and positive predictive value of 0.62 for a diagnosis of major depression.

At baseline, immediately after completion of titration, at 3 months, 6 months, and 12 months of maintenance phase.
Quality of life (QOL)
Lasso di tempo: At baseline, immediately after completion of titration, at 3 months, 6 months, and 12 months of maintenance phase.

The quality of life is measured by means the Quality Of Life In Epilepsy (QOLIE-31-P) questionnaire. This is a 38 questions survey of health-related quality of life for adults (18 years or older) with epilepsy. This version differs from the original QOLIE-31 (version 1) in the addition of questions about how much distress you feel about problems and worries related to epilepsy. This questionnaire should be completed only by the person who has epilepsy (not a relative or friend). Patients are asked to answer every question by circling the appropriate number (1, 2, 3...).

At baseline, immediately after completion of titration, at 3 months, 6 months, and 12 months of maintenance phase.
Cognitive assessment
Lasso di tempo: At baseline, immediately after completion of titration, at 3 months, 6 months, and 12 months of maintenance phase.

The assessment of perceived cognitive deficits is measured through the Perceived Deficits Questionnaire (PDQ-5). The PDQ-5 assesses cognitive dysfunction in people with depression. This patient-reported questionnaire includes five items measuring attention/concentration, retrospective memory, prospective memory, and planning/organization over the past four weeks. The total score ranges from 0 to 20; higher scores indicate greater perceived cognitive dysfunction.

At baseline, immediately after completion of titration, at 3 months, 6 months, and 12 months of maintenance phase.
Adverse events (AEs)
Lasso di tempo: Through study completion, an average of 1 year

Number of Adverse events (AEs) occurred (including AEs of special interest as Drug Reaction with Eosinophilia and Systemic Symptoms, rash/hypersensitivity, etc.).

Through study completion, an average of 1 year

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Collaboratori

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

2 maggio 2023

Completamento primario (Effettivo)

30 settembre 2025

Completamento dello studio (Effettivo)

30 settembre 2025

Date di iscrizione allo studio

Primo inviato

21 marzo 2023

Primo inviato che soddisfa i criteri di controllo qualità

17 maggio 2023

Primo Inserito (Effettivo)

19 maggio 2023

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

13 novembre 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

10 novembre 2026

Ultimo verificato

1 novembre 2026

Maggiori informazioni

Termini relativi a questo studio

Altri numeri di identificazione dello studio

  • 169(A)MD21254

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .